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Adults Hospitalized with COVID-19 —United States, March-June and October-December 2020: Implications for the Potential Effects of COVID-19 Tier-1 Vaccination on Future Hospitalizations and Outcomes
- Sami, Samira;
- Tenforde, Mark W;
- Talbot, H Keipp;
- Lindsell, Christopher J;
- Steingrub, Jay S;
- Shapiro, Nathan I;
- Ginde, Adit A;
- Douin, David J;
- Prekker, Matthew E;
- Erickson, Heidi L;
- Brown, Samuel M;
- Peltan, Ithan D;
- Gong, Michelle N;
- Khan, Akram;
- Exline, Matthew C;
- Files, D Clark;
- Gibbs, Kevin W;
- Rice, Todd W;
- Casey, Jonathan D;
- Grijalva, Carlos G;
- Stubblefield, William B;
- Womack, Kelsey N;
- Hager, David N;
- Qadir, Nida;
- Chang, Steven Y;
- Henning, Daniel J;
- Wilson, Jennifer G;
- Self, Wesley H;
- Patel, Manish M;
- Investigators, The IVY Network
- et al.
Published Web Location
https://doi.org/10.1093/cid/ciab319Abstract
Background
Because of the increased risk for severe coronavirus disease 2019 (COVID-19), the Advisory Committee on Immunization Practices (ACIP) initially prioritized COVID-19 vaccination for persons in long-term care facilities (LTCF), persons aged ≥65 years, and persons aged 16-64 years with high-risk medical conditions when there is limited vaccine supply. We compared characteristics and severe outcomes of hospitalized patients with COVID-19 in the United States between early and later in the pandemic categorized by groups at higher risk of severe COVID-19.Methods
Observational study of sampled patients aged ≥18 years who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and admitted to one of 14 academic hospitals in the United States during March-June and October-December 2020. Demographic and clinical information were gathered from electronic health record data.Results
Among 647 patients, 91% met ≥1 of the following risk factors for severe COVID-19 [91% March-June (n = 434); 90% October-December (n = 213)]; 19% were LTCF residents, 45% were aged ≥65-years, and 84% had ≥1 high-risk condition. The proportion of patients who resided in a LTCF declined significantly (25% vs 6%) from early to later pandemic periods. Compared with patients at lower risk for severe COVID-19, in-hospital mortality was higher among patients at high risk for severe COVID-19 (20% vs 7%); these differences were consistently observed between March-June and October-December.Conclusions
Most adults hospitalized with COVID-19 were those recommended to be prioritized for vaccination based on risk for developing severe COVID-19. These findings highlight the continued urgency to vaccinate patients at high risk for severe COVID-19 and monitor vaccination impact on hospitalizations and outcomes.Many UC-authored scholarly publications are freely available on this site because of the UC's open access policies. Let us know how this access is important for you.
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